Kidney tumors can range from a cyst to a solid growth originating from within the renal tissue.
Most tumors of kidney are discovered incidentally as a result of an imaging study such as an ultrasound or a CAT scan that was ordered for another reason.
Common Kidney Tumors
Renal cysts are very common and half of the population over the age of fifty years old will have at least one. On less common condition, renal cysts can be passed on from generation-to-generation and one such condition is known as polycystic kidney disease.
The two classes of renal cysts are simple and complex. Simple renal cysts are usually a fluid collection surrounded by a narrow wall of tissue. Most simple cysts do not need to routine surveillance, as they do not usually become cancerous. Complex cysts of the kidney usually also contain fluid but may occasionally be thicker than the fluid found in a simple cyst. In addition, a complex cyst may have a wall that is irregularly thicken with additional tissue and / or calcification as well as internal septation as well. Complex cysts usually will need to monitor regularly as they have the potential of becoming cancerous.
If a kidney tumor is suspected to be “solid” in nature then an imaging workup is usually the workup required to see if it “enhances” when radiographic contrast is given if an individual renal function is adequate.
Kidney Tumor Tests
The most common study is usually a CAT scan of the abdomen and pelvis with and without contrast. Other options can also include an MRI with contrast, a renal ultrasound.
When a kidney tumor enhances with a contrast study, the likelihood of it being cancerous in nature is very high. In most cases, only the imaging study is needed before moving forward with treatment.
However, on rare occasion, a biopsy of the kidney tumor maybe recommended by the surgeon and it can be performed percutaneously using some form of image guidance. Besides the risk of bleeding after a biopsy, there is a small risk of seeding the tumor along the biopsy tract.
As mentioned previously, most simple renal cysts are usually benign and do not require any intervention. However, larger renal cysts can occasionally create abdominal and/or back pain and they can either be drained and sclerosed percutaneously or laparoscopically.
For solid tumors, depending on the size, location, and or stage of the disease, either the entire kidney or just the tumor will have to be removed.
Depending on the stage of the patient, either an open or laparoscopic procedure will be recommended. Other alternative to the management of renal tumor may also involve either cryoablation or radio-frequency ablation.
During the last decade, the use of the Intuitive da Vinci surgical system has also become more popular as the concept of renal preservation surgery has become more common.
For patients suffering from early stage of renal cell carcinoma, surgical intervention is usually the first line of treatment.
However, in more advance disease, those patients may receive oral chemotherapy and / or immune therapy.